Civilians cowered in hospital beds and trapped residents struggled to feed their children Saturday, as Pakistani warplanes pounded a Taliban-held valley in what the prime minister called a "war of the country's survival."

Warplanes and troops killed dozens of entrenched militants Saturday in the assault on northwestern Swat Valley, the army said.

The offensive has prompted the flight of hundreds of thousands of terrified residents, adding a humanitarian emergency to the nuclear-armed nation's security, economic and political problems. Desperate refugees looted U.N. supplies in one camp, taking blankets and cooking oil.

A suspected U.S. missile strike killed nine people, mostly foreigners, in South Waziristan, another militant stronghold near the Afghan border, Pakistani intelligence officials said. The identities of the victims remained unclear.

Prime Minister Yousuf Raza Gilani directed millions of dollars to help the residents of a region where faith in the government is shaky, saying the army "can only be successful if there is support of the masses."

Gilani held an emergency Cabinet meeting Saturday. Speaking to reporters afterward, he called the Swat offensive a "war of the country's survival" but said the military could win.

Encouraged by the Washington, Pakistan's leaders launched the full-scale offensive on Thursday to halt the spread of Taliban control in districts within 60 miles (100 kilometers) of the capital, Islamabad.

Pakistan's army is fighting to wrest Swat and neighboring districts from militants who dominate the adjoining tribal belt along the Afghan frontier, where U.S. officials say Al Qaeda chief Usama bin Laden is likely holed up.

Witness accounts indicate that scores of civilians have already been killed or injured in the escalating clashes in the Swat, Buner and Lower Dir districts.

Even the medics are gone: Only three doctors remained Saturday at the hospital in Swat's main town, Mingora — all of them working flat out.

One of the patients, Omar Ali, said a mortar shell had crashed through the roof of his home near Mingora on Wednesday, killing his eight-year-old son. Ali, his wife and four more children were injured. Neighbors pulled them from the rubble and brought them to hospital.

"We are in pain. We are helpless and homeless," the tearful 45-year-old government worker told an Associated Press reporter who visited the clinic. "Even here, we are scared because we keep hearing explosions, gunfire and the noise of planes."

Nisar Khan, one of the three doctors left, said about 25 war-wounded were among the 100 patients.

It was unclear how many people remained in Mingora, but one resident too scared to try to flee said he was running short of food for his three children.

"We have no electricity, no running water, and we are almost out of food, milk and other things. We do not know what to do," Ikramullah Khan said.

"My wife has been mixing a few drops of milk into water just to make it look like milk. The younger children are not fooled. They just cry," he said.

Taliban militants seized much of the area under a peace deal, even after the government agreed to their main demand to impose Islamic law in the region.

U.S. officials likened the deal to a surrender. Pakistani leaders said the agreement's expected collapse had opened the eyes of ordinary citizens to the extremist threat.

The army says 12,000 to 15,000 troops in Swat face 4,000 to 5,000 militants, including small numbers of foreigners and hardened fighters from the South Waziristan border region.

On Saturday, an AP reporter saw military jets flying over Mingora and later heard explosions from further up the valley.

The military said its helicopter gunships attacked militant hide-outs in Mingora and killed 15 fighters. An estimated 30 to 40 more died in smaller clashes elsewhere, the statement said. Four soldiers were wounded.

The army accused militants of causing civilian casualties with indiscriminate mortar fire.

However, officials have given no details of civilian casualties, apparently for fear of a public outcry that could make it hard for the army to press ahead.

Provincial Information Minister Iftikhar Hussain blamed the Taliban for the deaths of innocents.

"The militants are using civilian population as a human shield and they have dug trenches in civilian areas," Hussain said at a news conference in Peshawar. He said the militants were firmly in control of Mingora.

Just south of the war zone, around the city of Mardan, crude refugee camps have mushroomed. On Saturday, the desperation of the refugees was laid bare, with television footage showing dozens of men making off with blankets and tins of cooking oil. A policeman hit one looter with his rifle butt while a man wearing a T-shirt bearing a U.N. logo urged others to return their loot.

"When people are desperate, it's hardly surprising that things like this happen," said Ariane Rummery, a spokeswoman for the U.N. refugee agency.

The agency has registered some 150,000 people fleeing the latest fighting. Pakistani and U.N. officials say the total number displaced may reach half a million.